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Birth control is an integral part of many women’s lives. The newer method of receiving a birth control shot (DMPA) every Three (3) months versus taking a pill every day has become a convenient way of  birth control  for many women.

Depo-Provera is the most well known and used DPMA. This contraceptive is injected into a woman’s muscle every three months.

DMPA works to prevent pregnancy in three different ways:

1) Prevents ovaries from releasing eggs.

2) Thickens cervical mucus to act as a barrier preventing sperm from reaching the egg.

3) Changes the lining of the uterus to prevent implantation.

Birth Control Research Study Findings

New studies have shown, that there are some dental health risks involved with the DMPA shot. The study has found a possible link between injectable progesterone contraceptives (Depotmedrooxyprogesterone acetate-DMPA) and periodontal disease.

The researchers examined about 4,500 participants ranging in age from 15 to 44. These patients were confirmed to not be pregnant and all reported receiving DMPA shots in the past or never having received the contraceptive shot.

About 4% of the  research participants were currently using the  Depo Provera shot, and about 12% had used it in the past. All the participants were thoroughly examined by a dentist. The dentist recorded gum tissue health indicators, such as  presence of bleeding gums,  any gingival recession, as well as  periodontal probing to measure bone levels surrounding the teeth.

Bone loss, periodontal pockets, and gingival recession are hallmark signs of periodontal disease.

Birth Control Marielaina Perrone DDSResearchers found that those currently taking DMPA injections were about 73% more likely to have gingivitis,( Gum inflammation and bleeding, without periodontal bone loss). Those women who had previously used DMPA also had a slightly higher incidence of gingivitis but the level of risk was not significant enough to prove an association.The researchers also found that Hispanic and Black women were 30-50% more likely to have some form of periodontal disease. Women of lower economic levels or who had not visited the dentist within the past two years also had a higher rate of periodontal disease.

The researchers believe that the hormones played a major role in the presence of periodontal disease. Women receiving any hormone based contraceptive (like DMPA) injections need to pay extra  attention to their teeth and gums to help prevent periodontal disease. This should include regular dental visits along with professional cleanings every 3-6 months.

Periodontal Disease Impacts your Whole Body

This research has once again shown, a definite link between periodontal disease and your overall health. When your mouth becomes diseased it does not remain contained there. When periodontal disease advances, toxins are released into your bloodstream. These toxins promote inflammation and can have a negative impact on your heart and other organs. This combination of bacteria and inflammation has been linked to a number of chronic diseases. These include:

Heart Disease. People with periodontal disease are actually almost twice as likely to have heart disease.

Diabetes. Periodontal disease is considered a definite complication of diabetes. Patients with diabetes are more likely to have periodontal disease than those without. According to the Journal of Periodontology, not only does having diabetes increase the risk of periodontal disease but it also increases blood sugar which will lead to  diabetic complications including problems with healing.

Rheumatoid Arthritis. Rheumatoid arthritis and periodontal disease are both chronic inflammatory processes. It has been found that treating periodontal disease has reduced the effects of rheumatoid arthritis.

Cancer. Periodontal disease has been linked to several different cancers including pancreatic, kidney, and blood cancers.

Other disease links include Alzheimer’s Disease, Kidney Disease, Respiratory Disease, Pregnancy complications (premature birth and low birth weight), and Osteoporosis.

What to Do If You Take a Progesterone Contraceptive?

See your dentist more often, ( every 3-4 months) and amp up your home care. More frequent cleanings, and flossing after meals will help prevent complications and the advancement of periodontal disease. The sooner the problem is detected, the better your chances are at reversing the disease process through professional cleanings and proper oral hygiene. If periodontal disease progresses it can be treated. Most often,  a deeper cleaning called scaling and root planing will start the healing process. In more severe cases,  periodontal disease surgery may be required. Remember to ask your dentist and hygienist for better brushing and flossing techniques, and ask them how often you should be seen for cleanings.

 



Who would not want to use a good mouthwash before meeting that special someone for a kiss? Or just to feel minty fresh as you go about your day?

For years there has been a discussion regarding mouthwash use. This is because people are worried about the health risks associated with the alcohol based mouthwashes.

Mouthwash manufacturers have been touting extra benefits of mouthwash besides minty fresh breath. Many tout themselves as washing plaque away, teeth whitening, as well as bacteria killers and as cavity fighters.

Are all these extra benefits possible? Is mouthwash use good for you?………

Advantages of using a Mouthwash

-Fluoride Mouthwashes. Fluoride mouthwashes do have the ability to possibly help reduce cavities. There have been many studies over the years to prove that fluoride can strengthen and reduce the breakdown of enamel thereby reducing the possibility of tooth cavities. This will not work for all but has been proven to be a benefit. Some fluorides are good antibacterials as well and help fight periodontal disease (stannous fluoride).

-Fight Periodontal Disease. Periodontal disease is caused by plaque from bacteria and food that sticks to teeth. As the bacteria feed on the food particles they release acid that will break down the bone and irritate the gum tissue. Our body responds by producing more acids to kill the bacteria. This causes bone loss and inflamed, infected gums. An antibacterial mouthwash may help prevent periodontal disease by lowering the amount of bad bacteria in the mouth.

Listerine Mouthwash - Marielaina Perrone DDS

Listerine Mouthwash

-Help during pregnancy or during a systemic disease process. It is important to maintain good oral hygiene at all times but for certain members of our population it is even more important. For pregnant women it can be critical. During pregnancy, a woman’s hormones are elevated which makes them more susceptible to developing periodontal disease if their oral hygiene is not maintained. Periodontal disease in pregnant women has been linked to pre term and low weight babies. For others it is a matter of survival. Patients with systemic diseases that make them more susceptible to infection like diabetics need to reduce the bacteria they are ingesting. It is even more critical to maintain good oral hygiene and mouthwashes are definitely recommended for those patients.

Disadvantages of using a Mouthwash

Canker Sore Irritant. This is caused when the alcohol content in your mouthwash is too high. It will irritate the canker sore and make it quite uncomfortable to use.

-Masks bad breath but does not remove the cause. Use of a mouthwash can definitely lead to fresher breath but it is usually quite short lived. Only some mouthwashes are formulated to actually neutralize odor causing chemicals, such as Closys. Not maintaining proper oral hygiene, or chemicals from your diet are usually the underlying factor in most people’s bad breath but the mouthwash will just mask it for a short time.

Alcohol based mouthwash. Studies (Listerine) have shown that rinses with alcohol, if used as directed can actually cause saliva production to be stimulated in a semi dry mouth. The alcohol in mouth rinses has historically been used as a way to cause the essential oils (the bacteria killing aspect) in the rinse to keep from separating out in the liquid, and staying mixed. No one wants to rinse with something oily feeling. There are now quite a few alternatives to alcohol to do the job, so alcohol free rinses have become more prevalent. Many people do not like the burning sensation of alcohol, and in people with little to no saliva flow, alcohol based rinses can be quite uncomfortable. The choice is based on personal preferences.

-Tartar dissolving rinse.There is a type of rinse (Periogen) that has been found to dissolve tartar, stains, and plaque. This rinse is a great way to keep your teeth from rebuilding tartar between cleanings. This is a powder that can be diluted with water in a waterpik and tends to be even more effective if a capful of your fluoride rinse is added to it.

Bottom Line on Mouthwash Use

Bottom line is mouthwashes are an aide and not a substitute for maintaining good oral hygiene. This should include proper brushing, flossing, and visiting your dentist regularly.

Mouthwash clearly offers certain advantages. But it’s important to know that not all mouthwash is the same. Saltwater rinses can be made at home with warm water and salt, whereas store-bought types contain a variety of ingredients ranging from fluoride (Act) to alcohol (Listerine) to highly specific antibacterial (Peridex).

In the end, each individual must choose the one that is right for them. For patients with periodontal disease, an antibacterial rinse like Listerine would be recommended to reduce the amount of bacteria in the mouth. For those patients who are cavity prone, a high fluoride mouthwash would be the choice. These mouthwashes only work effectively if paired with a good oral hygiene regimen. Talk to your dentist about which rinse would work best for you.

 

 

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